The purpose of the study was to evaluate the difference in outcomes between traditional closed Neuro critical care models to our Neuro critical Care model with heightened awareness to complex neuroscience disease management. 

Standards established in Epilepsy & Certified Stroke Centers (CSC) involve physicians with neuro critical care privileges to provide onsite care in dedicated neuro-intensive beds.  Evidence based research indicates an intensivist model is best to manage patients within a neurosurgical intensive care unit (NSICU) to reduce morbidity and mortality. While many models employ a closed unit model utilizing residents, fellows, or advanced practice nurses with Neurointensivists, our semi-open model provides for the use of neurospecialists to impart the highest level of care.

From January 1, 2014 to July 1, 2019 our center conducted a retrospective chart review of patients who were admitted to the NSICU with a primary diagnosis of ischemic stroke, intracranial hemorrhage, subarachnoid hemorrhage and seizures. The outcomes of our hospital were compared with similar diagnosis of patients at epilepsy and stroke programs and those within all hospitals.

Different models of neuro critical care exist; however, the principles of neuro critical care are identical. Utilizing a multidisciplinary approach in a semi-open unit allows the multidisciplinary team to care for the most challenging and highest acuity patients without concerns for services provided.   Further research is needed to reduce confounding variables; however, a semi-open critical care model can show an improvement in outcomes, allowing multidisciplinary evidence based rounds and expert consultations with collaboration of trained Neuro Critical Care providers.